[Pregnancy, puerperium and cerebrovascular disease]

Intracranial pressure and laboratory parameters in high- and low-risk pregnant women

BACKGROUND

Pregnancy can trigger several pathological changes, thus representing a great challenge for gynecology and obstetrics. The objective is to evaluate high- and low-risk pregnant women through Intracranial pressure (ICP) and laboratory parameters.

METHODS

Volunteers clinical and laboratory data were collected from medical records and ICP was monitored through noninvasive method.

RESULTS

Statistically significant differences were observed between the group of high-risk and low-risk pregnant women for serum levels of alkaline phosphatase (ALP) and US-C-reactive protein (CRP) and a statistically positive association between blood pressure (BP) levels and plasma glucose. About 12.77% of the volunteers presented altered ICP. Higher BP values were encountered with the higher plasma glucose values. All ICP altered volunteers presented altered BP. ALP is among the most effective biochemical markers for assessing the risk of premature birth before 32 weeks of gestation.

CONCLUSION

We have observed important changes on BP, serum glucose, US-CRP, and ALP thus indicating higher risk of complications during pregnancy. Even more, some of the volunteers presented altered ICP what could indicate cerebral compliance changes.

Chagas disease and anticardiolipin antibodies in older adults

Infectious agents have been implicated in the induction of antiphospholipid antibodies and the development of antiphospholipid antibody syndrome. The objective of this study was to evaluate the association of anticardiolipin antibodies with Chagas' disease antibodies. A total of 45 patients, who were positive for Chagas' disease (American Trypanosomiasis) antibodies and had elevated levels of anticardiolipin antibodies, were investigated in a case-control study. Twenty-four of the patients were male and 21 female with ages ranging from 60 to 81 years and with a mean age of 68.3 years. Twenty-three female and 11 male individuals from a senior citizen support group who were apparently healthy formed a control group. Their ages varied from 62 to 80 years with a mean of 68 years. The measurement of anticardiolipin antibodies was performed by means of enzyme-linked immunoabsorbent assay (ELISA) for quantitative measurement of IgG and IgM antibodies against cardiolipins in serum and evaluation of Chagas' disease was confirmed by the Machado Guerreiro test. Statistical analysis was made using Fisher's exact test with a confidence interval of 95% and a p-value <0.05. Elevated levels of anticardiolipin antibodies were detected in 48.8% of the patients and in 26.4% of the control group giving a p-value <0.038 using the Fisher's exact test. Thus, an association between Chagas' disease antibodies and anticardiolipin antibodies was evidenced in this series of patients.

Acidente vascular cerebral em pacientes jovens: análise de 164 casos

Realizamos análise epidemiológica de 164 pacientes com AVC, cujo primeiro episódio ocorreu entre 15 e 49 anos de idade através de um estudo retrospectivo de pacientes ambulatoriais. O principal tipo de apresentação foi AVC isquêmico (AVCI) em 141 pacientes, ocorrendo AVC hemorrágico (AVCH) em16 casos e 7 pacientes com trombose venosa. A presença de fatores de risco aterotrombóticos foi prevalente, em 48,22% dos pacientes com AVCI sendo que a hipertensão arterial sistêmica (HAS), nos casos de AVCH, foi a etiologia mais frequente. Em 32% dos casos não se pode determinar a sua causa. Embora a população jovem possua determinantes diferentes e geralmente deva ter uma investigação etiológica mais abrangente, no grupo estudado foram prevalentes os fatores de risco conhecidos e potencialmente controláveis, sugerindo que campanhas de prevenção e detecção precoce devam ser incentivados.